ICD-10 Coding for Bloody Stool(K92.1, K62.5, R19.5)
Complete ICD-10-CM coding and documentation guide for Bloody Stool. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Bloody Stool
K92.0-K92.2Primary Range
Other diseases of the digestive system
These codes cover various forms of gastrointestinal bleeding, including hematemesis and melena.
Hemorrhage of anus and rectum
This code is used for bright red rectal bleeding not specified as melena.
Other fecal abnormalities
This code is used for occult blood in stool when no specific source is identified.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K92.1 | Melena | Use when black, tarry stools are documented, indicating upper GI bleeding. |
|
| K62.5 | Hemorrhage of anus and rectum | Use for bright red blood per rectum without evidence of melena. |
|
| R19.5 | Other fecal abnormalities | Use when occult blood is found in stool without visible bleeding. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for bloody stool
Essential facts and insights about Bloody Stool
Primary ICD-10-CM Codes for bloody stool
Decision Criteria
clinical Criteria
- Presence of black, tarry stools
documentation Criteria
- Documentation of upper GI source
Applicable To
- Black tarry stools
Excludes
- Bright red blood per rectum (K62.5)
Clinical Validation Requirements
- Hgb drop ≥2 g/dL
- Positive fecal occult blood test
- Upper endoscopy showing bleeding source
Code-Specific Risks
- Misclassification if stool color is not specified
Coding Notes
- Ensure documentation specifies stool color and suspected bleeding source.
K62.5 - Hemorrhage of anus and rectum
Use for bright red blood per rectum without evidence of melena.
Applicable To
- Bright red blood per rectum
Excludes
- Melena (K92.1)
Clinical Validation Requirements
- Normal BUN:Cr ratio
- Colonoscopy showing rectal source
Coding Notes
Document the absence of melena and specify the rectal source.
R19.5 - Other fecal abnormalities
Use when occult blood is found in stool without visible bleeding.
Applicable To
- Occult blood in stool
Excludes
- Melena (K92.1)
- Bright red blood per rectum (K62.5)
Clinical Validation Requirements
- Positive fecal occult blood test
- Stable Hgb levels
Coding Notes
Ensure documentation supports the absence of visible blood.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Bloody Stool to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K92.1.
Impact
Clinical: Leads to inappropriate treatment decisions., Regulatory: Fails to meet documentation standards., Financial: May result in claim denials or reduced reimbursement.
Mitigation Strategy
Train staff on detailed documentation practices, Use templates to ensure comprehensive notes
Impact
Reimbursement: Incorrect coding may lead to lower reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Impacts data accuracy for GI bleeding statistics.
Mitigation Strategy
Use K92.1 when melena is documented.
Impact
Reimbursement: May result in claim denial or adjustment., Compliance: Violates coding exclusivity rules., Data Quality: Leads to inaccurate clinical data.
Mitigation Strategy
Use I84.2 alone when hemorrhoids are the source.
Impact
Using non-specific codes when detailed documentation is available.
Mitigation Strategy
Implement regular coding audits and staff training.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Bloody Stool, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Bloody Stool
Use these documentation templates to ensure complete and accurate documentation for Bloody Stool. These templates include all required elements for proper coding and billing.
Gastroenterology Progress Note
Specialty: GastroenterologyRequired Elements
- Stool color and consistency
- Duration and volume of bleeding
- Diagnostic test results
- Treatment response
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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